Abstract:
BACKGROUND:Impairment of cerebral autoregulation is known to adversely affect outcome following traumatic brain injury (TBI). The phase shift (PS) method of cerebral autoregulation (CA) assessment describes the time lag between fluctuations in arterial blood pressure (ABP) and cerebral blood flow velocity (CBFV) in the middle cerebral artery. An alternative method (Mx-ABP) is based on the statistical correlation between ABP and CBFV waveforms over time. We compared these two indices in a cohort of severely head injured patients undergoing controlled, 6-breaths-per-minute ventilation. METHODS:PS and Mx-ABP were calculated from 33 recordings of CBFV and MAP in 22 patients with TBI. Spearman's correlation coefficient was used to assess the agreement between PS and Mx-ABP. The relationship between ICP slow wave amplitude, MAP slow wave amplitude and mean ICP was also examined. FINDINGS:Mean values for Mx-ABP and PS were 0.44 +/- 0.27, and 49 +/- 26 (degrees), respectively. PS correlated significantly with Mx-ABP (r = -0.648, p < 0.001). A Bland-Altman plot of normalised Mx-ABP and Phase Shift values showed no significant bias or relationship (mean difference = 0.0004, r = -0.037, p = 0.852). During the test procedure, ICP fluctuated in an approximately sinusoidal fashion, with a mean amplitude of 4.96 +/- 2.72 mmHg (peak to peak). The magnitude of ICP fluctuation during deep breathing correlated weakly but significantly with mean ICP (r = 0.391, p < 0.05) and with the amplitude of ABP fluctuations (r = 0.625, p < 0.0005). CONCLUSIONS:Phase shift and Mx-ABP in TBI are well correlated. Deep breathing presents as an effective tool with which to assess autoregulation using the phase shift method.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Lewis PM,Rosenfeld JV,Diehl RR,Mehdorn HM,Lang EWdoi
10.1007/s00701-007-1447-zsubject
Has Abstractpub_date
2008-02-01 00:00:00pages
139-46; discussion 146-7issue
2eissn
0001-6268issn
0942-0940journal_volume
150pub_type
杂志文章abstract:BACKGROUND:Our current understanding of the role of dequalinium chloride (DECA) in the progression of glioma remains very limited. This study was aimed to investigate the effect of DECA on human glioma cell lines in vitro and vivo. METHODS:The underlying molecular mechanism was analyzed for developing potential target...
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abstract:BACKGROUND:Intra-operative monitoring of the position of the central sulcus (CS) is indispensable to properly treat a peri-motor cortex lesion. Noninvasive preoperative studies for identification of CS are also needed for choosing the optimal operative procedure. Magneto-encephalography (MEG) has recently been introduc...
journal_title:Acta neurochirurgica
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abstract::In Europe only few neurosurgeons are trained in both open surgical clipping as well as in endovascular techniques for treatment of intracranial aneurysms. To investigate the safety and efficacy of performing both techniques we, two dual trained neurosurgeons, analyzed our results in repairing ruptured intracranial ane...
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journal_title:Acta neurochirurgica
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更新日期:1990-01-01 00:00:00
abstract::We present the case of a 51-year-old female who had a four-year history of Parkinson's disease with severe "on-off' and disabling progression of symptoms on chronic levodopa therapy. After obtaining FDA approval, we implanted a Medtronic deep brain stimulation lead stereotactically into the right anterior pallidum con...
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